Approach to encephalopathy (acute and subacute) Quiz: Ace Your Exams
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A 28-year-old woman is brought to the emergency department by family members for evaluation of altered mental status. The family describes waxing and waning confusion and forgetfulness over the past 3 weeks. Past medical history includes recurrent urinary tract infections and cellulitis. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 18/min, and blood pressure is 120/72 mmHg. The patient is alert but disoriented. Bilateral scleral icterus and jaundice are noted, and the liver edge is palpable. When asked to extend both arms, the patient exhibits a flapping motion of the hands. Which of the following aspects of the medical history is most likely to reveal the underlying diagnosis?
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